COVID-19 vaccination and infection not associated with increased risk of congenital anomalies

1. In a cohort of infants born to mothers during the COVID-19 pandemic, neither vaccination nor infection with COVID-19 led to increased risk of any congenital anomaly. 

Evidence Rating Level: 1 (Excellent) 

There is an increased risk of pregnancy complications in women who contract COVID-19 while pregnant. As a result, it is highly recommended that pregnant women get vaccinated against COVID-19 to prevent transmission. Since there are not many past studies on the effects of vaccinations during pregnancy, these researchers attempted to understand the risk of the fetus developing congenital anomalies from exposure to COVID-19 (whether through the vaccination or infection) during the first trimester. This prospective-based study included 343 066 liveborn singleton births in Sweden, Denmark, and Norway with an estimated pregnancy start time between March 1, 2020, and February 14, 2022. Covid-19 vaccination, and infection were used as two separate exposures. Major congenital anomalies were defined according to the EUROCAT (European Surveillance of Congenital Anomalies) classification. The analyses were done separately for each country and then combined using a random effects meta-analysis. Among the infants in the study, 17,704 received a diagnosis of a major congenital anomaly, and 737 of those infants (4.2%) had anomalies in multiple subgroups. Only 3% (10 299) of the infants had mothers who got a COVID-19 infection during the first trimester. Common trends seen in these women include higher parity, lower educational level, lower household income, and born in the Middle East or Africa.  Ultimately there was not an increased risk of developing any major congenital anomalies after the mother had a COVID-19 infection (odds ratio [OR] 0.96; 95% confidence interval [CI] 0.87 to 1.05). Similarly, there was no increased risk of having any congenital anomalies in infants whose mothers were vaccinated in the first trimester (OR, 1.03; 95% CI 0.97 to 1.09). Further assessment showed adjusted ranges from the lowest of 0.84 (0.31 to 2.31) for nervous system anomalies to the highest of 1.69 (0.76 to 3.78) for abdominal wall defects. Maternal vaccination or infection with COVID-19 did not lead to an increased risk of any major congenital anomalies in their infants. 

Click to read the study in BMJ

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